Surgeries and Rheumatoid Arthritis

Many of you have had surgeries. Some of you have had surgeries since the diagnosis of rheumatoid arthritis. Then, there are those of you who are new to rheumatoid arthritis and have no idea what that means if you need surgery.

In August 2020, I will be having my 20th and 21st surgeries. Yes, you read that correctly! Since my diagnosis of fibromyalgia in 2005 I have had 10 surgeries, 6 of which happened after my rheumatoid arthritis diagnosis in early 2013. Everything is different with RA, especially surgery.

Stopping RA medications leading up to surgery

Surgeries vary in difficulty and complexity. What effect surgeries have on your RA and its treatment varies widely also.

Knee replacements and carpal tunnel repairs

When I had my knee replacements, I had to stop my RA medications and my Celebrex for 2 weeks before surgery and not resume until the stitches were out and the site had healed. For my carpal tunnel repairs, RA meds were stopped one week prior and until the site had healed.

Cataract surgeries

My upcoming surgeries are cataract surgeries. On one eye, they are doing a glaucoma procedure as well.

I contacted my rheumatologist via the portal and asked about my Rinvoq. He said, “For uncomplicated cataract surgeries, you do not need to stop the Rinvoq.” I emailed back about the glaucoma procedure and asked if that made it complicated. The response was to stop the Rinvoq 5 days prior to the procedure and resume once the ophthalmologist states it is healed.

The importance of surgery preparation

What I have demonstrated is the first rule of having surgery when you have RA: contact your rheumatologist ASAP to determine your plan. Timing and dosing are critically important. I have found that preparation makes everything go well.

Preparation tips for a successful surgery

1. Call your rheumatologist ASAP to determine if and what changes are necessary to your treatment plan.

2. Get refills of all medications prior to surgery.

3. Read and digest all the pre-surgical information you are given.

4. Be sure to ask the surgeon about what to expect during and after surgery.

5. Make sure your surgeon knows about your RA.

6. After surgery, your mouth will be very dry. Make sure to have plenty of fruits, water, and your favorite non-alcoholic drinks on hand.

7. Make food ahead or ask friends/church to bring meals.

8. Do laundry the day before, put clean sheets on the bed, clean towels in the bathroom.

9. Arrange for a driver.

10. If you are having joint replacement, do the pre-surgery exercises and the rehab exercises.

11. If you are having back/spine surgery, do the rehab and continue home exercises for life. Your spine will stay in better shape and you are less likely to have problems later.

12. Have ice on hand if you need it for swelling after surgery.

13. Set up your home for success. Remove throw rugs, clear pathways, get a shower chair.

14. Prepare a positive attitude toward surgery and recovery.

Healing from surgery

These are tips I use prior to all my surgeries. Knowing what to expect enables you to move toward the final goal of little to no pain. Bear in mind that the pain medications given after surgery will not remove all your pain. They lessen the pain so that you can accomplish what is necessary during rehab.

Surgery is a season. Think of it as your least favorite season. As you rehab and recover, remind yourself that you are moving toward your favorite season.

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